DBT Counseling

Dialectical behavior therapy is a technique I like to employ when working with clients because I think it just makes sense! It equips clients to learn how to tolerate distressing emotions, regulate emotions, practice mindfulness, and foster interpersonal effectiveness.

One of the skills that I find goes under the radar at times is the emotion regulation skill that uses the acronym PLEASE. (DBT is full of acronyms to help make skills useable and easy to remember.)

Here is the breakdown of please and my thoughts of why each is important to maintaining good mental health:

PL-Treat physical illness. When you are sick it is often hard to function at your optimal performance. This applies to just more than acute illnesses like the flu. Chronic illness and pain can cause people to lose interest in activities, work, and social interaction which only deepens depression. Further, illnesses such as hypothyroidism have been linked with depression. I recommend all my clients consult with a general physician regularly to monitor their physical health.

E- Eating. Research is looking more to out gut health and how this effects our brain. Eating a variety of nutritious foods keeps our gut microflora healthy and producing over 90% of our brain’s serotonin- our happy neurotransmitter! I recommend clients consult with a dietician to discuss your body and brain’s nutrition needs.

A-Altering drugs- Drugs can easily exacerbate the symptoms of mental illness. In fact, part of my job at times is determining whether the symptoms a client is experiencing the result of a mental illness or the result of a substance. Popular drugs such as synthetic cannabinoids have been known to cause severe psychotic symptoms. Additionally, altering drugs can effect medication use and make recovery from mental illness difficult.

S- Sleep. I don’t know about you but I get straight up cranky when I am tired. Sleep is critical to help our mind “reset” its neurotransmitters. Sleep is critical for our body’s to rest and restore as well. Every person has different needs in relation to sleep, but the general recommendation of 8 hours is a good average for most people. Those who do shift work are often prone to depression as their circadian rhythm or sleep-wake cycle, is disrupted from the natural norm which generally follows daylight hours. In fact, shift work disorder, is a new term that is being treated with a new class of medications similar to other stimulants on the market. Any sleep-related concerns can be addressed with your doctor or a sleep specialist.

E- Exercise- Are you sick of hearing about diet and exercise yet? General recommendations of the American Heart Association advocate for 150 minutes of light to moderate exercise per week. That’s about 30 minutes for 5 days each week. Exercise boost our neurotransmitters including dopamine and norepinephrine which are involved in our “feel good” responses, as I like to call them. Exercises such as yoga, which incorporate mindfulness, have been indicated through research in virtually every illness and mental illness. Mindfulness helps keep the body in a more relaxed state and lessen the effects of the sympathetic nervous system, or “fight-or-flight” response. Exercise is also a great way to connect with family, friends, or even make new friends. Check with your doctor about which exercise is most appropriate for you. Some people even like to see a trainer to develop an effective workout routine and gain accountability.

Treating your body well directly relates to keeping your mind well. Don’t forget the acronym PLEASE to ensure you are taking care of all aspects of yourself.

Written by:

Kristina Zufall, M.Ed., LPC-Intern